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General NPI Number Information
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NPI Number | 1336229343
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Entity Type | Individual
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Provider Name | GREGORY NICHOLAS MAZZOTTA D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 09/24/2008
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Provider Practice Location Address
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Address Line | 1490 NE MIAMI GARDENS DR
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City | N MIAMI BEACH
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State | FL
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Zip | 33179-4829
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Country | US
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Telephone | 305-944-3310
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Fax | 305-944-8655
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Provider Business Mailing Address
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Address Line | 2601 SW 37TH AVE SUITE 607
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City | MIAMI
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State | FL
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Zip | 33133-2700
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Country | US
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Telephone | 305-445-5056
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Fax | 305-445-2023
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8707
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License Number State | FL
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